ABSTRACT
There is a lack of knowledge on the histologic outcomes of loop electrosurgical excision procedure (LEEP) biopsies in the diagnosis, treatment, and prevention of cervical cancer in Zambia. This study determined the outcomes of LEEP biopsies and associated factors at a tertiary hospital. We conducted a retrospective chart review of patients evaluated at a tertiary hospital cervical cancer screening centre. From the database, we identified patients who underwent LEEP between January 2015 and June 2018. We extracted demographic data, HIV data, and LEEP biopsy results. A P value less than 0.05 was considered statistically significant. 137 charts were identified, and 114 were included in the final analysis. 23 were excluded for missing histology. The mean age of participants was 36.3 ± 9.6. Histology outcomes revealed that 37% had cervicitis, while CIN 1, 2, and 3 contributed to 27%, 14%, and 3%, respectively. Squamous cell cancer was present in 8% (age groups 35-49) and was three times higher (13%) in HIV-positive compared to HIV-negative participants (3.8%). Normal histology accounted for 11%. Increasing age (P=0.029), less than tertiary education (P=0.0011), and being married (P=0.017) increased the chances of having cancer in the chi-square analysis, while single women had lower odds of having CIN 1 (OR = 0.012) in the multinomial logistic regression. There is a need for increased cervical cancer screening and training in precancer treatment and holistic consideration of other factors like age in addition to the positive VIA test in advising patients on treatment options.
ABSTRACT
BACKGROUND: Poor quality of food services in hospital contributes to low diet satisfaction among inpatients in both developed and developing countries. However, there is paucity of literature on diet satisfaction in health care facilities in the sub-Saharan region and in particular Zambia. Therefore, this study sought to assess levels of diet satisfaction among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia. METHODS: A hospital-based cross-sectional study was conducted over a period of three months. Comprehensive sampling was used to select 98 study participants. A researcher-administered questionnaire adapted from a similar study was used to collect data. The instrument used in this study had 9 aspects of satisfaction. Descriptive statistics such as frequencies, percentages, means and standard deviations were used to analyze the data. Chi-square test was used to test for associations between categorical data. A p-value of less than 0.05 was considered to be statistically significant. RESULTS: In this study, 64.3% of surgical orthopaedic inpatients were not satisfied with overall quality of hospital food. In addition, 76.5, 96.9, 65.3 and 71.4% of the patients were not satisfied with type, variety, appearance and taste of hospital food respectively. However, patients who were satisfied with portion size, temperature and time of meal distribution were 67.3, 94.9 and 56.1% respectively. There was no significant association between variables of age, sex, education level, marital status, monthly income, days in hospital and overall satisfaction (p > 0.05). CONCLUSION: Low diet satisfaction is a global problem associated with poor quality of hospital meals. Although the majority of surgical orthopaedic inpatients were not satisfied with more than half of the dimensions of diet satisfaction, they were satisfied with aspects of portion size, temperature and time of meal distribution. Therefore, an assessment of diet satisfaction can inform hospital administrators and policy makers on the deficiencies in hospital diets and thereby help improve quality of meals.
ABSTRACT
BACKGROUND: Sub-optimal dietary intake among in-patients including those with orthopaedic injuries is one of the factors that contributes to malnutrition and poor clinical outcomes in hospitals. The purpose of this study was to determine adequacy of intake of selected nutrients among adult surgical orthopaedic patients on standard hospital diet. METHODS: A hospital-based cross-sectional study involving 98 adult surgical orthopaedic patients aged 18-64 years and admitted in low cost wards was conducted. A 24 h dietary recall was used to record food intake in the previous 24 h. Adequacy of energy, protein, calcium, iron, zinc, dietary fibre, sodium, folic acid and vitamin C were determined using nutrition standards for adult inpatients in one state of Australia. Food frequency of consuming selected foods was assessed using standard 7-day food frequency questionnaires. Data was collected over a period of three months. RESULTS: The findings on nutrient intake indicated that mean energy, protein, calcium, sodium, iron, zinc, folic acid, dietary fibre and vitamin C intake were all below the recommended values (1919Cal, 61.67 g, 160.05 mg, 222.91 mg, 10.19 mg, 2.55 mg, 165.98 µg, 20.09 g and 22.60 mg respectively). Further, 24.4%, 8.5%, 26.7%, 5.5% and 15.2% of the participants met the Recommended Dietary Intakes (RDIs) of energy, protein, iron, vitamin C and dietary fibre respectively. Hospital food contributed more than 60% of the total nutrient intake of energy, protein, folic acid and dietary fibre. CONCLUSION: In this study, the mean consumption intake for all the selected nutrients was below the recommended dietary intakes. Since sub-optimal dietary intake is associated with malnutrition and poor clinical outcomes, it is recommended that the hospital should provide diets that meet the nutrient demands of adult inpatients.
ABSTRACT
BACKGROUND: Nutritional risk and undernutrition are common problems among medical and surgical patients. In hospital, malnutrition is frequently under-diagnosed and untreated thereby contributing to morbidity and mortality. The purpose of this study was to determine the prevalence of nutritional risk among adult inpatients at a teaching hospital in Zambia. In addition, the study sought to establish factors associated with nutritional risk. METHODS: A hospital-based cross-sectional study comprising of 186 consecutive in-patients aged 18-64 years admitted in medical and surgical wards was conducted at a teaching hospital. Out of one hundred and ninety eight (198) patients eligible to participate, complete data were collected from 186, representing a response rate of 93.9%. The Malnutrition Universal Screening Tool was used to collect data over a period of six months. Evaluated patients were dichotomized into no risk and nutritional risk. Binary logistic regression was performed to identify variables associated with nutritional risk. RESULTS: The mean age of adult in-patients was 40.72 ± 14.4 years. Majority of the patients were male (61.8%), while 38.2% were female. Results indicate that 59.7% of hospitalized patients were at nutritional risk. Vomiting, weakness, appetite decrease, dysphagia and weight loss were significantly associated (p = 0.019, p = 0.008, p < 0.001, p = 0.007, and p < 0.001 respectively) with nutritional risk. However, weight loss and appetite decrease were the most significant factors associated with nutritional risk (OR = 50.16, 95% CI = 5.75-36.70, p < 0.001 and OR = 28.06, 95% CI =1.49-8.12, p = < 0.001 respectively). CONCLUSION: Findings of our study suggest that close to 60% of adult inpatients at the teaching hospital were at nutritional risk. Nutritional risk is an issue of major concern at the teaching hospital and is associated with a number of variables. Identification of nutritional risk using Malnutrition Universal Screening Tool among adult inpatients is feasible in resource-poor settings like ours.
